Effects Of A Novel Probiotic On Exercise-Induced Gut Permeability and Microbiota in Endurance Athletes

Abstract

Exercise-induced hyperpermeability of the gastrointestinal (GI) tract contributes to abdominal pain, bloating, and fatigue; symptoms commonly expressed in Inflammatory Bowel Disease, Celiac’s Disease, and Type 1 Diabetes. Therapies that can ameliorate the symptoms and conditions are lacking. PURPOSE: To assess the efficacy and feasibility of Lactobacillus Salivarius (UCC118) supplementation on GI permeability in healthy humans. METHODS: In a randomized, double blind crossover study, 7 highly-trained endurance athletes (31 ± 6.11 y, VO2max ≥ 57.3 ± 9.3 ml/kg/min) received 4 weeks of daily probiotic or placebo supplementation. The initial 4 week period was followed by a 4 week washout, followed by an additional 4 weeks of placebo or probiotic supplementation. GI permeability, blood chemistry, and fecal microbiota were assessed before and after each 4 week intervention period. GI permeability was challenged using 2 hours of continuous treadmill running at 60% VO2max. After 20 minutes of running, subjects ingested 5 grams of L-rhamnose, sucrose, and lactulose. Urine was collected before, immediately after, and every hour for 5 hours after exercise. GI permeability was measured as sugar recovered in urine as determined by LC-MS/MS. Metagenomic sequencing was performed on fecal samples with Illumina HiSeq 4000 utilizing a 2 x 150 configuration for an average of 120-130M paired end reads per sample. Beta diversity was estimated using Bray-Curtis method to reveal the microbial diversity between pre and post intervention samples. RESULTS: Compared to placebo, UCC118 treatment reduced area under the curve for urine (N=5) sucrose (P=0.081) and rhamnose recovery (P=.100). Gut taxonomy sequencing revealed significant changes in 60 bacterial species (P<0.05) after UCC118 supplementation. Additionally, there was an increase in microbial diversity after probiotic use. CONCLUSION: The results described herein provide proof of principle that 4 weeks of UCC118 supplementation attenuates exercise-induced intestinal hyperpermeability. Molecular processes are ill-defined, so further investigation is needed to determine associated pathways, protein interactions, and impact of specific bacterial taxa. Study supported by external sponsor.